Abstract 3220: Melanoma patients in the emergency department: Characteristics and outcomes
Authors: Henna Hundal, Kamil Taneja, Karan Patel, James E. Siegler, Jesse Thon, Jeeyong Shin, Hailey Hsiung, Michael Diaz, Eric M. Toloza
Journal: Cancer Research (2023)

Abstract Introduction: In the US, 78,000 new melanoma cases are diagnosed every year. Melanoma patients often present to the emergency department (ED). However, few studies have identified the common reasons for these patients to present to the ED. Methods: We utilized the 2006-2012 Nationwide Emergency Department Sample to identify the most common primary diagnoses for ED visits by melanoma patients. Multi-variable logistic regression was used to identify characteristics that were associated with higher chance of inpatient admission. A p-value &amp;lt;0.05 was considered significant. Results: Between 2006 and 2012, 239,956 melanoma patients presented to the ED. Most patients were ≥70 years old (50.7%), male (53.6%), Medicare beneficiaries (60.5%), of the highest income quartile (31.5%), living in the South (35.5%), presenting to non-trauma hospitals (49.6%), and presenting to metropolitan non-teaching hospitals (45.3%). Most patients (57.6%) were admitted. Common primary diagnoses for melanoma patients in the ED were secondary malignancy (5.3%), chest pain (4.8%), cardiac arrhythmia (3.3%), pneumonia (3.1%), and complications related to a prior surgery or medical treatment (2.7%). Primary diagnoses associated with the highest risk of inpatient admission were septicemia (odds ratio [OR]=29.2, 95% confidence interval (CI)=19.2-44.5; p&amp;lt;0.001), secondary malignancy (OR=16.5, 95%CI=13.4-20.2; p&amp;lt;0.001), and acute cerebrovascular disease (OR=4.6, 95%CI=3.7-5.8; p&amp;lt;0.001). The primary diagnoses associated with the lowest risk of inpatient admission were contusion (OR=0.09, 95%CI=0.07-0.11; p&amp;lt;0.001), abdominal pain (OR=0.18, 95%CI=0.15-0.22; p&amp;lt;0.001), and lower respiratory disease (OR=0.21, 95%CI=0.17-0.25; p&amp;lt;0.001). Table 1 lists the 20 most common primary diagnoses associated with risk of admission. Conclusion: Melanoma patients frequently present to the ED for many reasons, with septicemia and a secondary malignancy being the most common diagnoses for inpatient admission. Risk of Inpatient Admission Based on Primary Diagnosis in the Emergency Room for Melanoma Patients Primary Diagnosis in the ED Odds Ratio (95% Confidence Interval) p-value Septicemia 29.2 (19.2-44.6) &amp;lt;0.001 Secondary Malignancy 16.5 (13.4-20.2) &amp;lt;0.001 Pneumonia 4.60 (3.86-5.47) &amp;lt;0.001 Acute Cerebrovascular Disease 4.60 (3.68-5.77 &amp;lt;0.001 Congestive Heart Failure 3.06 (2.50-3.81) &amp;lt;0.001 Coronary Artery Disease 2.95 (2.28-3.82) &amp;lt;0.001 Arrhythmia 1.82 (1.60-2.07) &amp;lt;0.001 Fluid or Electrolyte Disorder 1.68 (1.41-2.01) &amp;lt;0.001 Skin Infection 1.33 (1.16-1.51) &amp;lt;0.001 Complicaiton of Prior Surgery or Medical Treatment 1.23 (1.07-1.43) 0.005 Chronic Obstructive Pulmonary Disease 1.12 (0.97-1.30) 0.128 Urinary Tract Infection 0.98 (0.85-1.12) 0.741 Myocardial Infarction 0.96 (0.88-1.05) 0.376 Nervous System Disorder 0.75 (0.63-0.89) 0.001 Syncope 0.69 (0.59-0.81) &amp;lt;0.001 Chest Pain 0.32 (0.29-0.37) &amp;lt;0.001 Spondylosis 0.28 (0.24-0.34) &amp;lt;0.001 Lower Respiratory Disease 0.21 (0.17-0.25) &amp;lt;0.001 Abdominal Pain 0.18 (0.15-0.22) &amp;lt;0.001 Contusion 0.09 (0.07-0.11) &amp;lt;0.001 Citation Format: Henna Hundal, Kamil Taneja, Karan Patel, James E. Siegler, Jesse Thon, Jeeyong Shin, Hailey Hsiung, Michael Diaz, Eric M. Toloza. Melanoma patients in the emergency department: Characteristics and outcomes [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3220.